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Surgical Treatment for Cerebral Aneurysm after Incomplete Guglielmi Detachable Coil Embolization Satoshi KURODA 1 , Satoshi USHIKOSHI 2 , Yoshimasa NIIYA 1 , Toshiya OSANAI 1 , Tatsuya ISHIKAWA 1 , Shugo TAKIKAWA 3 , Kiyohiro HOUKIN 4 , Yoshinobu IWASAKI 1 1Department of Neurosurgery,Hokkaido University Guraduate School of Medicine 2Department of Radiology,Hokkaido University Guraduate School of Medicine 3Department of Neurosurgery,Chitose City Hospital 4Department of Neurosurgery,Sapporo Medical University Keyword: intracranial aneurysm , coiling , clipping , bypass surgery , subarachnoid hemorrhage pp.645-650
Published Date 2004/6/1
DOI https://doi.org/10.11477/mf.1436100406
  • Abstract
  • Look Inside

 The frequency of surgical treatment for intracranial aneurysms that have been incompletely treated by endovascular coiling will increase in time. The authors describe their experience in the following 3 patients. There was one non-ruptured aneurysm and two ruptured ones. The intervals between coiling and surgery were 1,5,and 10 months. Surgery was indicated because of partial treatment and/or growth of residual neck. Observation during surgery revealed that coils were exposed to the subarachnoid space at the tip of the aneurysm in the cases of ruptured aneurysms. When the residual neck was large enough for the size of the clip blades,there was no need to remove the coils. The coils in the neck were able to be removed when the interval between coiling and surgery was very short,but could not be removed when the interval was prolonged. Intraoperative angiography and reconstructive bypass surgery may be essential in these complex cases. As pointed out previously,the operative approach should be determined by the need for coil removal and the duration since coiling.


Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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